Most ulcers occur in the first layer of the inner lining. A hole that goes all the way through the stomach or duodenum is called a perforation
. A perforation is a medical emergency.

The most common cause of ulcers is infection of the stomach by bacteria called Helicobacter pylori (H.pylori). Most people with peptic ulcers have these bacteria living in their digestive tract. Yet, many people who have these bacteria in their stomach do not develop an ulcer.

The following factors raise your risk for peptic ulcers:

Drinking too much alcohol

Regular use of aspirin, ibuprofen, naproxen, or other nonsteroidal anti-inflammatory drugs (NSAIDs). Taking aspirin or NSAIDs once in a while is safe for most people.

Bismuth (the main ingredient in Pepto-Bismol) may be added to help kill the bacteria

If you have an ulcer without an H. pylori infection, or one that is caused by taking aspirin or NSAIDs, your doctor will likely prescribe a proton pump inhibitor for 8 weeks.

You may also be prescribed this type of medicine if you must continue taking aspirin or NSAIDs for other health conditions.

Other medicines used for ulcers are:

Misoprostol, a drug that may help prevent ulcers in people who take NSAIDs on a regular basis

Medicines that protect the tissue lining (such as sucralfate)

If a peptic ulcer bleeds a lot, an EGD may be needed to stop the bleeding. Methods used to stop the bleeding include:

Injecting medicine in the ulcer

Applying metal clips to the ulcer

Surgery may be needed if:

Bleeding cannot be stopped with an EGD

The ulcer has caused a tear

Outlook (Prognosis)

Peptic ulcers tend to come back if untreated. There is a good chance that the H. pylori infection will be cured if you take your medicines and follow your doctor’s treatment advice. You will be much less likely to get another ulcer.

Possible Complications

Severe blood loss

Scarring from an ulcer may make it harder for the stomach to empty

Perforation or hole of the stomach and intestines

When to Contact a Medical Professional

Get medical help right away if you:

Develop sudden, sharp abdominal pain

Have a rigid, hard abdomen that is tender to touch

Have symptoms of shock
, such as fainting, excessive sweating, or confusion

Vomit blood or have blood in your stool (especially if it's maroon or dark, tarry black)

Call your doctor if:

You feel dizzy or light-headed

You have ulcer symptoms

Prevention

Avoid aspirin, ibuprofen, naproxen, and other NSAIDs. Try acetaminophen instead. If you must take such medicines, talk to your doctor first. Your doctor may:

For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.

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